Surgical gas delivery device with internal gaseous sealing module and filtered tube set therefor

ABSTRACT

A system for performing an endoscopic surgical procedure in a surgical cavity of a patient that includes a gas delivery device configured to deliver a flow of pressurized gas to a gas delivery lumen extending therefrom, a gaseous sealing module communicating with a distal end of the gas delivery lumen and configured to generate a gaseous seal within a gas sealed lumen extending therefrom, and an access port communicating with a distal end of the gas sealed lumen so as to provide sealed instrument access to the surgical cavity and maintain a stable pressure within the surgical cavity.

BACKGROUND OF THE INVENTION 1. Field of the Invention

The subject invention is directed to endoscopic surgery, and moreparticularly, to a surgical gas delivery device for use in endoscopicsurgical procedures that includes an internal or remote gaseous sealingmodule for generating a gaseous seal within a lumen extending therefromthat communicates with a mechanically sealed surgical access port tomaintain stable pressure within a surgical cavity.

2. Description of Related Art

The use of pneumatically sealed surgical access devices or trocars, suchas those that have been disclosed in commonly assigned U.S. Pat. Nos.7,854,724 and 8,795,223, in combination with a multi-modal gas deliverydevice, such as those that have been disclosed in commonly assigned U.S.Pat. Nos. 8,715,219; 8,961,451; 9,295,490 and 9,375,539 have beendemonstrated to have numerous advantages. These advantages includevalve-less access to a surgical cavity (e.g., the abdominal or thoraciccavity), facilitation of smoke evacuation, and stable maintenance ofpressure within the surgical cavity, as well as several medical andclinical benefits.

The combination of these devices form a surgical system that relies onthe presence of an annular jet assembly housed within the trocar forreceiving pressurized gas from the gas delivery device to generate agaseous sealing zone within the body of the trocar. That annular jetassembly is disclosed in commonly assigned U.S. Pat. No. 9,907,569, andit is designed to provide a static mechanism akin to a nozzle thatfunnels down pressurized gas into a narrower passage that increases thevelocity of the gas in order to generate the gaseous sealing zone.

In commonly assigned U.S. Pat. Nos. 9,387,295 and 9,387,296, as well asin commonly assigned U.S. Application Publication No. 2016/0287817, itwas proposed to move the location of the annular jet assembly (or asimilar nozzle design) from the trocar device and into the filtercartridge housing of a related filtered tube set configured foroperative associate with the gas delivery device. This enabled the useof more conventional commercially available access devices instead ofthe pneumatically sealed trocars described above.

It has now been determined that further advantages can be achieved bymoving the location of the annular jet assembly (or a similar nozzledesign) into the tubing of a filtered tube set or into the housing of amulti-modal gas delivery device itself. This would enable the technologyto be compatible with a multitude of new proprietary andcommercially-available end effectors and access devices. Indeed, incertain surgical scenarios, it may be required that all of the accessports used in a procedure be of one variety. For example, these mayinclude robotically assisted surgeries that are only compatible with acertain type or brand of reusable cannulas.

Another advantage of the gas management systems of the subject inventionwould be market or cost-driven, wherein hospitals have policies to usedisposable cannulas of a particular brand (for example due to afinancial contract) or reusable cannulas to save money. In theseexamples, the systems of the subject invention would enable a surgeon togain pressure-stability and smoke evacuation functionality without therequirement to displace one of their lower-cost access ports.

SUMMARY OF THE DISCLOSURE

The subject invention is directed to a new and useful system forperforming an endoscopic surgical procedure in a surgical cavity, whichincludes a gas delivery device configured to deliver a flow ofpressurized gas to a gas delivery lumen extending therefrom, a gaseoussealing module communicating with a distal end of the gas delivery lumenand configured to generate a gaseous seal within a gas sealed lumenextending therefrom, and an access port communicating with a distal endof the gas sealed lumen so as to provide mechanically sealed instrumentaccess to the surgical cavity and maintain a stable pressure within thesurgical cavity. The access port includes a valve sealed proximalhousing for providing mechanically sealed instrument access to thesurgical cavity.

The system further includes a gas return lumen extending from thegaseous sealing module back to the gas delivery device. The gas deliverydevice includes a pump for delivering pressurized gas to the gasdelivery lumen and for suctioning gas from the gas return lumen. The gasdelivery lumen and the gas return lumen communicate with a filterassembly that is dimensioned and configured for reception within the gasdelivery device.

The system further includes an insufflator within the gas deliverydevice for delivering insufflation gas to a second access port throughan insufflation lumen. The second access port includes a mechanicallysealed proximal housing for providing sealed instrument access to thesurgical cavity.

Preferably, the gaseous sealing module includes a housing supporting ajet assembly for receiving pressurized gas from the gas delivery lumento generate the gaseous seal, and wherein gas spent generating thegaseous seal is suctioned through the gas return lumen back to the pumpin the gas delivery device. In an embodiment of the subject invention,the gaseous sealing module includes a vented housing for facilitatingair entrainment from atmosphere into the surgical cavity and gas releaseto atmosphere from the surgical cavity. It is envisioned that thegaseous sealing module could also communicate with a bi-directionalfiltration element to filter entrained air and/or gas released toatmosphere from the surgical cavity.

In one embodiment, the housing of the gaseous sealing module isconfigured such that the connections for the gas delivery lumen and thegas return lumen are arranged perpendicular to the connection for thegas sealed lumen. In another embodiment, the housing of the gaseoussealing module is configured such that the connection for the gasdelivery lumen and the gas return lumen are arranged in-line with theconnection for the gas sealed lumen. In yet another embodiment, thehousing of the gaseous sealing module is configured such that theconnection for the gas delivery lumen and the gas return lumen arearranged in parallel to the connection for the gas sealed lumen.

In these embodiments, it is envisioned that the gas delivery lumen andthe gas return lumen could be arranged to interface with the housing ofthe gaseous sealing module in a parallel configuration or in aconcentric configuration. Alternatively, the gaseous sealing modulecould include a two-part housing assembly having a proximal subassemblyconnected to the gas delivery lumen and the gas return lumen, and adistal sub-assembly connected to the gas sealed lumen.

The subject invention is also directed to a system for performing anendoscopic surgical procedure in a body cavity, which includes a gasdelivery device having a pump for delivering pressurized gas to a gasdelivery lumen extending therefrom and having an insufflator fordelivering insufflation gas to an insufflation lumen extendingtherefrom. A gaseous sealing module communicates with a distal end ofthe gas delivery lumen, external to the gas delivery device, and it isconfigured to generate a gaseous seal within a gas sealed lumenextending therefrom. A gas sealed sleeve having a proximal end portioncommunicates with a distal end portion of the gas sealed lumen, and atubular access port configured for coaxial installation within the gassealed sleeve and having a valve sealed proximal housing providingmechanically sealed instrument access to the surgical cavitycommunicates with a distal end of the insufflation lumen.

An annular channel is formed between an inner surface of the sleeve andan outer surface of the access port so that the gas sealed lumen is incommunication with the surgical cavity to maintain a stable pressurewithin the surgical cavity. A sealing ring is associated with theproximal end portion of the gas sealed sleeve for sealing a proximal endof the annular channel, and a plurality of circumferentially spacedapart flow channels are formed in the distal end portion of the gassealed sleeve to facilitate communication between the annular channeland the surgical cavity. The system further includes a gas return lumenextending from the gaseous sealing module back to the pump in the gasdelivery device. The gas delivery lumen and the gas return lumencommunicate with a filter assembly that is dimensioned and configuredfor reception within the gas delivery device.

The subject invention is also directed to a novel method of accessing asurgical cavity of a patient, which includes the steps of: providing agas sealed sleeve; installing a valve sealed trocar into the gas sealedsleeve; and introducing the gas sealed sleeve together with theinstalled valve sealed trocar into the surgical cavity of the patient.The method further comprises the steps of connecting the sleeve to a gassealed lumen adapted for bi-directional gas flow to and from the sleeve,and connecting the trocar to an insufflation and sensing lumen.

The subject invention is also directed to a system for performing anendoscopic surgical procedure in a surgical cavity, which includes a gasdelivery device housing a pump configured to deliver pressurized gas toan internal gas delivery lumen extending from the pump. A gaseoussealing module is housed within the gas delivery device, incommunication with the gas delivery lumen and configured to generate agaseous seal within an internal gas sealed tube extending therefrom. Thegas sealed tube is adapted and configured to communicate with a gassealed lumen extending externally from the gas delivery device, and avalve sealed access port communicates with a distal end of the gassealed lumen so as to provide mechanically sealed instrument access tothe surgical cavity and maintain a stable pressure within the surgicalcavity.

The system further includes an internal gas return lumen that extendsfrom the gaseous sealing module to recirculate gas used to form thegaseous seal back to the pump within the gas delivery device. The gasdelivery device also includes an insufflator for delivering insufflationgas to a second valve sealed access port through an insufflation lumen.

In this embodiment of the subject invention, the gaseous sealing modulepreferably includes an integral assembly formed by a metallic disk withat least one radially inwardly angled nozzle formed therein forgenerating the gaseous seal, and a cylindrical bore for accommodatingair entrainment into and gas release from the gas sealed lumen.

It is envisioned that the at least one radially inwardly angled nozzlecan be radially spaced apart from the cylindrical bore, which could beoffset from a central axis of the disk. Alternatively, the disk can havea plurality of radially inwardly angled nozzles formed therein, whichwould be radially spaced apart from the cylindrical bore, which could beoffset from a central axis of the disk. Or, the disk could have aplurality of radially inwardly angled nozzles formed therein, whichsurround the cylindrical bore, which could be aligned with a centralaxis of the disk.

The subject invention is also directed to a tube set for use with a gasdelivery device for performing an endoscopic surgical procedure in asurgical cavity, which includes a filter cartridge assembly having firstand second flow paths formed therein, a first lumen extending from thefilter cartridge and communicating with the first flow path forcommunicating with the surgical cavity to maintain a stable pressuretherein and facilitate smoke evacuation, and a second lumen extendingfrom the filter cartridge and communicating with the second flow path todeliver insufflation gas to the surgical cavity and sense cavitypressure.

A fitting is operatively associated with a distal end of the first lumenfor connection with a first mechanically sealed access port, and afitting is operatively associated with a distal end of the second lumenfor connection with a second mechanically sealed access port. There maybe at least one filter element disposed within the first flow path ofthe filter cartridge, and/or at least one filter element disposed withinthe second flow path of the filter cartridge.

These and other features of the gas circulation system and the system ofthe subject invention will become more readily apparent to those havingordinary skill in the art to which the subject invention appertains fromthe detailed description of the preferred embodiments taken inconjunction with the following brief description of the drawings.

BRIEF DESCRIPTION OF THE DRAWINGS

So that those skilled in the art will readily understand how to make anduse the gas circulation system and gas sealed surgical access devices ofthe subject invention without undue experimentation, preferredembodiments thereof will be described in detail herein below withreference to the figures wherein:

FIG. 1 is an illustration of the gas delivery system of the subjectinvention during an endoscopic surgical procedure conducted within theabdominal cavity of a patient, wherein the system includes a gasdelivery device, gas delivery and return lines extending between the gasdelivery device and a remote gaseous sealing module, a first valvesealed access port communicating with the gas sealed lumen attached tothe gaseous sealing module, and an insufflation and sensing lineextending between the gas delivery device and a second valve sealedaccess port.

FIG. 2 is a perspective view of the filtered tube set, remote gaseoussealing module and valve sealed access ports of the gas delivery systemillustrated in FIG. 1;

FIG. 3 is an exploded perspective view of a portion of the gas deliverysystem of FIG. 1, illustrating the connections between the gas deliveryand return lines, the remote gaseous sealing module, the gas sealedlumen, and the first valve sealed access port;

FIG. 4 is an exploded perspective view of the gaseous sealing module ofthe gas delivery system shown in FIG. 1, with parts separated for easeof illustration;

FIGS. 5 and 6 are top and bottom perspective views of the nozzle tubeelement that forms part of the gaseous sealing module shown in FIG. 4;

FIGS. 7 and 8 are cross-sectional views of the gaseous sealing moduletaken along lines 7-7 and 8-8 of FIG. 3;

FIG. 9 is an illustration of another embodiment of a filtered tube setfor use with the gas delivery device shown in FIG. 1, which includes gasdelivery and return lines extending between a filter cartridgeconfigured for reception in the gas delivery device, a remote gaseoussealing module having a two-part housing, a valve sealed access portcommunicating with the gas sealed lumen attached to the gaseous sealingmodule and an insufflation and sensing lumen communicating with anothervalve sealed access port;

FIG. 10 is an enlarged perspective view of a portion of the gas deliverysystem of FIG. 9, illustrating and the gas sealed lumen extendingbetween the gaseous sealing module and a first valve sealed access port,and the insufflation and sensing lumen and second valve sealed accessport;

FIG. 11 is an enlarged perspective view of the remote gaseous sealingmodule shown in FIG. 9;

FIG. 12 is an exploded perspective view of the remote gaseous sealingmodule shown in FIG. 9, with parts separated for ease of illustration,including the annular jet assembly for generating a gaseous seal in thegas sealed lumen extending therefrom;

FIG. 13 is an exploded perspective view of the annular jet assemblyhoused within the gaseous sealing module of FIG. 12;

FIG. 14 is an illustration of another embodiment of a filtered tube setfor use with the gas delivery device shown in FIG. 1, which includes gasdelivery and return lines extending between a filter cartridgeconfigured for reception in the gas delivery device, a remote gaseoussealing module, a valve sealed access port communicating with the gassealed lumen attached to the gaseous sealing module and an insufflationand sensing lumen communicating with another valve sealed access port;

FIG. 15 is an enlarged perspective view of a portion of the gas deliverysystem of FIG. 14, illustrating and the gas sealed lumen extendingbetween the gaseous sealing module and a first valve sealed access port,and the insufflation lumen and sensing lumen and second valve sealedaccess port;

FIG. 15a is a localized view of the connector for the gas delivery andreturn lines disconnected from the fitting on the gaseous sealingmodule;

FIGS. 16 and 17 are cross-sectional view taken along line 16-16 of FIG.15 illustrating the interior of the remote gaseous sealing module andthe connection point of the gas delivery and the gas return lumens;

FIG. 18 is a perspective view a surgical access assembly constructed inaccordance with a preferred embodiment of the subject invention thatincludes a gas sealed sleeve having a proximal end portion thatcommunicates with a distal end portion of a gas sealed lumen, and avalve sealed tubular access port configured for coaxial reception withinthe sleeve;

FIG. 19 is an exploded perspective view of the surgical access assemblyshown in FIG. 18, with the valve sealed tubular access port separatedfrom the gas sealed sleeve;

FIG. 20 is a perspective view of the filtered tube set of FIG. 14 inconjunction with the surgical access assembly of FIG. 18;

FIG. 21 is an exploded perspective view of the filtered tube set shownin FIG. 20, with parts separated for ease of illustration;

FIG. 22 is a cross-sectional view taken along line 22-22 of FIG. 18;

FIG. 23 is a localized plan view of the distal end portion of thesurgical access assembly shown in FIG. 18;

FIG. 24 is an illustration of another gas delivery system constructed inaccordance with a preferred embodiment of the subject invention whereinthe gas delivery device includes an internal gaseous sealing module thatcommunicates with a gas sealed lumen extending from a filter cartridgeto a valve sealed access port, and which also includes an insufflationand sensing lumen extending from the filter cartridge to a second valvesealed access port;

FIG. 25 is a perspective view of the filtered tube set employed with thegas delivery device of FIG. 24, with the valve sealed access portsassociated therewith;

FIG. 26 is a localized perspective view of the interior of the gasdelivery device shown in FIG. 24;

FIG. 27 is a cross-sectional view taken along line 27-27 of FIG. 24;

FIG. 28 is an exploded perspective view of the internal gaseous sealingmodule located within the gas delivery device shown in FIG. 24, withparts separated for ease of illustration;

FIG. 29 is a schematic representation of the gas delivery device of FIG.24, illustrating the gas flow paths associated therewith; and

FIGS. 30-37 depict four different embodiments of a one piece nozzle discfor generating a gaseous seal with the internal gaseous sealing moduleshown in FIG. 28.

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

Referring now to the drawings wherein like reference numerals identifysimilar structural elements and features of the subject invention, thereis illustrated in FIG. 1 a gas circulation system for performing anendoscopic surgical procedure in a surgical cavity of a patient, andmore particularly, for performing a laparoscopic surgical procedure inthe abdominal cavity of a patient, that is constructed in accordancewith a preferred embodiment of the subject disclosure and is designatedgenerally by reference numeral 10. Those skilled in the art will readilyappreciate that the gas circulation system 10 of the subject inventioncan be used for performing thoracoscopic surgical procedures in thethoracic cavity of a patient, as well as, the performance ofendo-luminal surgical procedures, such as trans-anal andtrans-esophageal surgical procedures.

Referring to FIG. 1, the gas circulation system 10 of the subjectinvention is specifically designed to cooperate with a programmablemulti-modal gas delivery device 12. The gas delivery device 12 is of thetype described, for example, in commonly assigned U.S. Pat. No.9,375,539, the disclosure of which is herein incorporated by referencein its entirety. The gas delivery device 12 includes a graphical userinterface 14 for setting operating parameters and a pump 16 forfacilitating the circulation/recirculation of pressurized gas relativeto the surgical cavity 18 of a patient 20. The gas delivery device 12 isconnected to a portable source of surgical gas 22 for deliveringinsufflation gas to the surgical cavity 18 of the patient 20 by way ofan internal insufflator 15. Alternatively, gas could be supplied to thegas delivery device 12 from a permanent source.

With continuing reference to FIG. 1 in conjunction with FIG. 2, thesystem 10 further includes a filtered tube set 30 that is operativelyassociated with the gas delivery device 12. The filtered tube set 30includes a disposable filter cartridge 32 of the type described incommonly assigned U.S. Pat. No. 9,526,849, the disclosure of which isherein incorporated by reference in its entirety. A gas delivery lumen34 and a gas return lumen 36 extend between the filter cartridge 32 anda remotely located gaseous sealing module 40, which will be described inmore detail below. A first valve sealed access port 42 communicates withthe gaseous sealing module 40 through a gas sealed lumen 44, and aninsufflation and sensing line 46 extends between the filter cartridge 32and a second valve sealed access port 48. A connector 43 is associatedwith a distal end of the gas sealed lumen 44 for mating with a fittingon the first access port 42, and a connector 47 is associated with adistal end of the insufflation and sensing line 46 for mating with afitting on the second access port 48.

Referring now to FIG. 3, the remote gaseous sealing module 40 (i.e.,located remote from the access port 42 and from the gas delivery device12) is shown in conjunction with the gas delivery and return lumen 34and 36, the gas sealed lumen 44 and the first valve sealed access port42. In general, the remote gaseous sealing module 40 is adapted andconfigured to generate a gaseous seal which extends through the gassealed lumen 44 to the first valve sealed access port 42 so as tomaintain a stable pressure and facilitate smoke evacuation within thesurgical cavity 18 of patient 20 during an endoscopic surgicalprocedure.

Referring to FIG. 4, the remote gaseous sealing module 40 includes agenerally cylindrical proximal housing portion 50 and an elongatedtubular stem portion 52 that extends axially from the proximal housingportion 50. The proximal housing portion 50 is associated with an endcap 55 having an axially offset inlet port 54 for communication with thegas delivery lumen 34 and an adjacent axially offset outlet port 56 forcommunication with the gas return lumen 36.

With continuing reference to FIG. 4 in conjunction with FIGS. 5 and 6,the gaseous sealing module 40 further includes a nozzle body 60sandwiched between the proximal housing portion 50 and the end cap 55,which defines crescent shaped inlet plenum 62 a for transmittingpressurized gas from the pump 16 of the gas delivery device 12 throughthe gas delivery lumen 34 and inlet 54 in end cap 55 for use ingenerating a gaseous seal within the gaseous sealing module 40, andcrescent shaped outlet plenum 62 b for receiving spent gas used to formthe gaseous seal within the gaseous sealing module 40 through outlet 56for return to the pump 16 via gas return lumen 36. The crescent shapedplenums 62 a and 62 b have respective crescent shaped gas conduitchannels 63 a and 63 b.

The nozzle body 60 of gaseous sealing module 40 further includes acentral gas transfer plenum 64, which is open to atmosphere at bothends, and is located between the inlet plenums 62 a and 62 b. Nozzlebody 60 also includes a distally extending nozzle tube 65 thatcommunicates with the gas transfer plenum 64. The nozzle tube 65 has acentral bore 70 that communicates with the gas transfer plenum 64 todefine a bi-directional vent path that facilitates gas exchange to andfrom the gas sealed gas sealed lumen 44, including but not limited to,air entrainment from atmosphere into the surgical cavity 18 and gasrelease to atmosphere from the surgical cavity 18 to relieveoverpressure. The outer periphery of nozzle tube 65 includes a pluralityof circumferentially spaced apart land areas 66, which define a set ofcircumferentially spaced apart recessed gas jets 68 for acceleratingpressurized gas delivered to the gaseous sealing module 40 from gasdelivery lumen 34 to form a gaseous seal within the gas sealed lumen 44.

With continuing reference to FIG. 4 in conjunction with FIGS. 7 and 8,the proximal housing portion 50 of gaseous sealing module 40 includes acentral cylindrical plenum area 72 in communication with the gas inletchannels 63 a of the inlet plenum 62 a of nozzle body 60, and asurrounding annular plenum area 74 in communication with the gas returnchannel 63 b of the gas return plenum 62 b. The annular plenum area 74incudes a plurality of circumferentially spaced apart gas return ports75.

A nozzle bore 76 is formed within the central plenum area 72, and asbest seen in FIGS. 7 and 8, the nozzle tube 65 of nozzle body 60 isdimensioned and configured for engagement within the nozzle bore 76 toform the radially outer boundaries of the circumferentially spaced apartjets 68 recessed into the outer peripheral surface of nozzle tube 65, asdescribed above.

Referring to FIG. 4 in conjunction with FIGS. 7 and 8, the elongatedtubular stem portion 52 that extends axially from the proximal housingportion 50 of gaseous sealing module 40 includes a proximal flangeportion 80 that houses a plurality of circumferentially spaced apartfins 82 configured to guide spent gas used to generate the gaseous sealback to the annular plenum area 74 by way of the gas return ports 75.The tubular stem portion 52 further includes a medial throat section 84,which defines the interior zone 85 of the gaseous sealing module 40wherein the gaseous seal is generated by the circumferentially spacedapart jets 68. The stem portion 52 also includes a distal tube fitting86 which is dimensioned and configured to connect with the gas sealedlumen 44, as best seen in FIG. 3.

Referring now to FIGS. 9 through 12, there is illustrated anotherfiltered tube set constructed in accordance with a preferred embodimentof the subject invention, which is designated generally by referencenumeral 130 and it includes a remote gas sealing module 140 that differsfrom the remote sealing module 40 described above, in that the gassealed delivery and return lumens are offset from and parallel to thegas sealed lumen.

More particularly, tube set 130 includes a filter cartridge 132, a gasdelivery lumen 134 and gas return lumen 136 extending between the filtercartridge 132 and the gaseous sealing module 140, a gas sealed lumen 144extending from the gaseous sealing module 140 to a first valve sealedaccess port 142, and an insufflation and sensing lumen 146 extendingfrom the filter cartridge 132 to a second valve sealed access port 148.In this embodiment of the invention, the gaseous sealing module 140 isconfigured such that the connection for the gas delivery lumen 134 andthe gas return lumen 136 are arranged parallel to and offset from theconnection for the gas sealed lumen 144.

Referring now to FIGS. 11 and 12, the remote gaseous sealing module 140includes a two-part mechanically interconnected housing assembly 145consisting of a first component 152 and a sub-assembly 157. The firstcomponent 152 is connected to and communicates with the gas deliverylumen 134 and gas return lumen 136. Sub-assembly 157 is connected to andcommunicates with the gas sealed lumen 144.

More particularly, component 152 of the two-part housing 145 has aninlet port 154 for direct communication with the gas delivery lumen 134and an adjacent outlet port 156 for direct communication with the gasreturn lumen 136. Sub-assembly 157 of the two-part housing 145 includesa body portion 155 defining an interior plenum chamber 159 and adistally extending tube fitting 186 which is dimensioned and configuredto connect with the gas sealed lumen 144.

The interior plenum chamber 159 of body portion 155 is dimensioned andconfigured to receive a two-part ring jet assembly 190 of the typeillustrated in FIG. 13, which is described in more detail in commonlyassigned U.S. Pat. No. 9,907,569, the disclosure of which isincorporated herein by reference in its entirety. In general, as shownin FIG. 13, the two-part ring jet assembly 190 is comprised of an uppermember 192 with an O-ring seal 193 and a lower ring member 194 with anO-ring seal 195.

The jet assembly 190 receives pressurized gas through an inlet port 163from the gas delivery lumen 134, and it functions to accelerate that gasso as to generate a gaseous seal within the distal throat area 184 ofbody portion 155 (see FIG. 10). The gaseous seal that is generated inthe throat area 184 creates a stable pressure barrier that maintainsstable pressure through the length of the gas sealed lumen 144 to accessport 142 so as to maintain a stable pressure and facilitate smokeevacuation within the surgical cavity 18 of a patient 20 during anendoscopic surgical procedure.

As best seen in FIG. 12, circumferentially spaced apart guide fins 182are provided within the plenum chamber 159 of body portion 155 forguiding the gas spent generating the gaseous seal within throat area 184back to the gas return lumen 136 by way of an outlet fitting 170.Component 152 also includes a vent path 188 that facilitate gas exchangeto and from the gas sealed lumen 144, including but not limited to, airentrainment from atmosphere into the surgical cavity 18 and gas releaseto atmosphere from the surgical cavity 18 to relieve overpressure.

Referring now to FIGS. 14 through 17, there is illustrated yet anotherfiltered tube set constructed in accordance with a preferred embodimentof the subject invention, which is designated generally by referencenumeral 230 and it includes a remote gas sealing module 240 that differsfrom each of the remote sealing modules described above. Moreparticularly, tube set 230 includes a filter cartridge 232, a gasdelivery lumen 234 and gas return lumen 236 extending between the filtercartridge 232 and the gaseous sealing module 240, a gas sealed lumen 244extending from the gaseous sealing module 240 to a first valve sealedaccess port 242 and an insufflation and sensing lumen 246 extending fromthe filter cartridge 232 to a second valve sealed access port 248.

In this embodiment of the invention, the gaseous sealing module 240 isconfigured such that the gas delivery lumen 234 and the gas return lumen236 are arranged perpendicular to the output for the gas sealed lumen244, and the gas delivery lumen 234 and gas return lumen 236 arearranged to interface with the housing 250 of the gaseous sealing module240 in a concentric configuration.

More particularly, the gas delivery lumen 234 and the gas return lumen236 are operatively associated with a rotatable dual lumen concentricconnector 235 that mates with a correspondingly configured fitting 245extending from the housing 250 of gaseous sealing module 240, in adirection perpendicular to the connection for the gas sealed lumen 244,as best seen in FIGS. 15a . A connector of this type is disclosed incommonly assigned U.S. Patent Application Publication No. 2017/0361084,the disclosure of which is herein incorporated by reference in itsentirety. The housing 250 of gaseous sealing module 240 further includesa louvered vent 280 that facilitates bi-directional gas exchange withatmosphere (i.e., for air entrainment and over pressure relief by way oflumen 244) and it is arranged in-line with the gas sealed lumen 244, asbest seen in FIGS. 16 and 17.

In this embodiment of the invention, the gaseous sealing module 240includes the two-part ring jet assembly 290 of the type shown in FIG. 13and described in commonly assigned U.S. Pat. No. 9,907,569, forgenerating a gaseous seal with the interior region 285 of the throatportion 284 of housing 250, which creates a stable pressure barrier thatmaintains stable pressure through the length of the gas sealed lumen 244to the access port 242 so as to maintain a stable pressure andfacilitate smoke evacuation within the surgical cavity 18 of a patient20 during an endoscopic surgical procedure.

Referring now to FIGS. 18 through 23, there is illustrated a surgicalaccess assembly 300 that is adapted and configured for use inconjunction with any one of the previously described filtered tube sets,such as for example, the filtered tube set 230 shown in FIG. 14. Thesurgical access assembly 300 primarily includes a tubular gas sealedsleeve 342 and a valve sealed access port 348. The tubular gas sealedsleeve 342 has a proximal end portion 343 that includes a fitting 347for communication with a connector 247 on the distal end portion of thegas sealed lumen 244 of tube set 230. The valve sealed access port 348is configured for coaxial installation within the tubular sleeve 342 toprovide mechanically sealed instrument access to the surgical cavity 18and it has a fitting 349 for communicating with a connector 249 on thedistal end of the insufflation and sensing lumen 246 of tube set 230.

As best seen in FIGS. 22 and 23, the access port 348 has a proximalhousing 365 that houses a duckbill seal 367 for providing sealed accessto the surgical cavity 18 through the central lumen 369 of the accessport 348. With specific reference to FIG. 22, the central lumen 369provides an insufflation and sensing path for the system 300, andelongated annular channel 353 is formed between an inner peripheralsurface of the gas sealed sleeve 342 and an outer peripheral surface ofthe access port 348 so that the gas sealed lumen 244 is in communicationwith the surgical cavity 18 to maintain a stable pressure and facilitatesmoke evacuation within the surgical cavity 18.

A sealing ring 355 is associated with the proximal end portion 343 ofthe sleeve 342 for sealing a proximal end of the annular channel 353,and a plurality of circumferentially spaced apart flow channels 357 areformed in the distal end portion 359 of the gas sealed sleeve 342 tofacilitate communication between the annular channel 353 and thesurgical cavity of a patient, as best seen in FIG. 23, therebymaintaining a stable pressure within the surgical cavity and facilitatesmoke evacuation during an endoscopic surgical procedure.

In use, to access the surgical cavity 18 with the access assembly 300during an endoscopic surgical procedure, the valve sealed port 348 isfirst installed into the gas sealed sleeve 342, and then the gas sealedsleeve 342 together with the valve sealed port 348 are introduced intothe surgical cavity 18 of the patient 20. The angled distal edge 363 ofthe valve sealed port 348 aids in the percutaneous introduction of theassembly 300, which would be accomplished using a typical obturator orintroducer placed therein, as is well known in the art.

The method further includes the steps of connecting the fitting 247 onthe end of the gas sealed lumen 244 to the fitting 347 of the sleeve342, which is adapted for bi-directional gas flow to and from the gassealed sleeve 342, and the step of connecting the fitting 249 on the endof the insufflation and sensing lumen 246 to the fitting 349 of thevalve sealed port 348. In the event that a metallic access device isused in this system, it is envisioned that the sleeve 342 would need tobe grounded to prevent an electrical shock resulting from capacitivecoupling.

Referring now to FIG. 24, there is illustrated a unique gas deliverysystem 400 constructed in accordance with a preferred embodiment of thesubject invention. Gas delivery system 400 includes a gas deliverydevice 412 that has an internal gaseous sealing module 440, as opposedto the external remotely located gaseous sealing modules describedabove. The gas delivery device 412 also includes a graphical userinterface 414 for setting operating parameters, an internal insufflator415 for receiving insufflation gas from a source and delivering that gasto the surgical cavity of the patient, and a pump 416 for facilitatingthe circulation/recirculation of pressurized gas relative to internalgaseous sealing module 440. The insufflator 415 and gaseous sealingmodule 440 communicates with a unique filtered tube set 430, which isbest seen in FIG. 25.

Referring to FIG. 25, the filtered tube set 430 includes a filtercartridge 432 from which extends a gas sealed lumen 444 and aninsufflation and sensing lumen 446. The gas sealed lumen 444 extendsfrom the filter cartridge 432 to a first valve sealed access port 442,and the insufflation and sensing lumen 446 extends to a second valvesealed access port 448. The internal gaseous sealing module 440generates a gaseous seal that creates a stable pressure barrier thatmaintains stable pressure through the gas sealed lumen 444 to the firstaccess port 442 to maintain a stable pressure and facilitates smokeevacuation within the surgical cavity of a patient during an endoscopicsurgical procedure.

Referring to FIGS. 26 through 27 in conjunction with the schematicdiagram of FIG. 29, there is illustrated the interior of the housing 413of the gas delivery device 412, which includes a reception cavity 417for releasably receiving the cartridge 432 of the filtered tube set 430,which communicates with the internal gaseous sealing module 440 by wayof an internal gas sealed tube 425. The filter cartridge 432 includes afirst filter element 431 for filtering insufflation gas flow to theinsufflation conduit 446 and a second filter element 433 for filteringgas flowing to and from the gas sealed lumen 444. While the filtercartridge 432 has been described as being part of the replaceable anddisposable tube set 430, it is envisioned and well within the scope ofthe subject disclosure that one or both of the filter elements 431 and433 could be in the form of a removable filter element installed in aninterior compartment within the housing 413 of gas delivery device 412,as shown for example in FIG. 29 (see, e.g., internal filter 457).

An internal insufflation tube 419 extends between the insufflator 415and the reception cavity 417. In addition, an internal gas deliveryconduit 421 extends from high pressure outlet side of the pump 416 tothe inlet side of the gaseous sealing module 440 and an internal gasreturn conduit 423 extends between the outlet side of the gaseoussealing module 440 and the inlet or suction side of the pump 416.

Referring to FIG. 26 in conjunction with FIG. 28, the gaseous sealingmodule 440 is supported with the housing 413 of the gas delivery device412 on an upstanding bracket 427 that includes a louvered vent plate 429for accommodating gas exchange, including but not limited to, airentrainment from atmosphere into the gaseous sealing module 440 and gasrelease to atmosphere from the gaseous sealing module 440. Asillustrated in FIG. 29, an embodiment of the gas delivery device 412includes an internal vent tube 455 that extends from the housing 450 ofthe gaseous sealing module 440 to an internal filter element 457. Theinternal filter 457 communicates with an outlet tube 459 that extendsfrom the housing 413 to atmosphere to facilitate gas exchange.

The housing 450 of the gaseous sealing module 440 is dimensioned andconfigured to support a pressurized nozzle assembly 490, which isadapted and configured to accelerate pressurized gas to generate agaseous seal within the throat section 484 that extends from the housing450 to the gas sealed tube 425. The nozzle assembly 490 includes anupper ring component 492 having an associated O-ring seal 493 and alower nozzle disk 494 having an associated O-ring seal 495. As explainedin more detail below, the nozzle disc 494 includes one or more gasaccelerating nozzles.

As best seen in FIG. 27, a gas inlet plenum 497 is formed between thelower surface of upper ring component 492 and the upper surface of thelower nozzle disk 494 for receiving pressurized gas from the internalgas delivery conduit 421. More particularly, the housing 450 includes aninlet port 451 for communicating with the gas delivery conduit 421 andan outlet port 453 for communicating with the gas return conduit 423.The nozzle assembly 490 defines a vent path 499 to facilitatebi-directional gas exchange with atmosphere, by way of the relief by wayof louvered vent plate 429.

Referring now to FIGS. 30-37, there are illustrated four differentembodiments of a metallic nozzle disc, each of which is adapted andconfigured to generate a gaseous seal within the internal gaseoussealing module 440 shown in FIG. 28, as explained above. In theseembodiments, each metallic disk is 594 is formed with at least oneradially inwardly angled nozzle 596 formed therein for acceleratingpressurized gas received from the pump 416 to generate the gaseous sealin the internal gaseous sealing module 444 of gas delivery device 412, acylindrical bore 598 for accommodating air entrainment into and gasrelease from the gas sealed lumen 444, and an O-ring seal 595 forsealing isolating the high and low pressure sides of the disk 594 withinthe housing 450 of module 440.

Referring first to FIGS. 30 and 31, an embodiment of the disk 594includes one radially inwardly angled nozzle 596 radially spaced apartfrom the cylindrical bore 598, both of which are offset from a centralaxis of the disk 594. An alternative embodiment of the disk 594, has aplurality of radially inwardly angled nozzles 596 formed therein, whichare radially spaced apart from the cylindrical bore 598, which are alloffset from a central axis of the disk, as illustrated in FIGS. 32 and33.

In another embodiment, the disk 594 has a plurality of radially inwardlyangled jet nozzles 596 formed therein, which surround the cylindricalbore 598, which is axially aligned with a central axis of the disk 594,as illustrated in FIGS. 34 and 35. In yet another embodiment of the disk594, there is one radially inwardly angled nozzle 596 that receivespressurized gas through a radial inlet passage 597 extending from anouter periphery of the disk 594, and the cylindrical bore 598 is axiallyaligned with a central axis of the disk 594, as illustrated in FIGS. 36and 37.

In essence, the cylindrical bore 598 in each of these metallic discs 594provides the same functionality as the central bore of a ring jetassembly for a gas sealed access port (see U.S. Pat. No. 8,795,223),which is centrally located to allow instrument passage. However, sincethe jet discs 594 are internal to the gas delivery device 412, and theydo not need to accommodate instrument passage, the cylindrical bore 598in each disk 594 does not need to be as large and it can be locatedoff-center. This is because a pneumatic seal does not need to be formedaround a cylindrical instrument passing through the access port. Whilethis bore is cylindrical for ease of manufacture, it need not be.

While the subject disclosure has been shown and described with referenceto preferred embodiments, those skilled in the art will readilyappreciate that changes or modifications may be made without departingfrom the scope of the subject disclosure.

1-14. (canceled)
 15. A filtered tube set for use with a gas deliverydevice for performing an endoscopic surgical procedure in a surgicalcavity, comprising: a) a filter cartridge assembly having first andsecond flow paths formed therein; b) a first lumen extending from thefilter cartridge and communicating with the first flow path forcommunicating with the surgical cavity to maintain a stable pressurelevel and facilitate smoke evacuation therein; and c) a second lumenextending from the filter cartridge and communicating with the secondflow path to deliver insufflation gas to the surgical cavity and tosense cavity pressure.
 16. A filtered tube set as recited in claim 15,wherein a fitting is operatively associated with a distal end of thefirst lumen for connection with a first valve sealed access port.
 17. Afiltered tube set as recited in claim 15, wherein a fitting isoperatively associated with a distal end of the second lumen forconnection with a second valve sealed access port.
 18. A filtered tubeset as recited in claim 15, wherein at least one filter element isdisposed within the first filtered flow path of the filter cartridge.19. A filtered tube set as recited in claim 15, wherein at least onefilter element is disposed within the second filtered flow path of thefilter cartridge.
 20. A filtered tube set as recited in claim 15,wherein the first lumen is configured for bi-directional gas flow so asto facilitate stable pressure in the surgical cavity and facilitatesmoke evacuation from the surgical cavity.